Renew Status of Standard Membership

renew status

documentation of any Disclosure information that falls outside of the Clean Slate Legislation Act 2004 (uploadable)

to make/arrange payment of the fee for $110.00 (incl GST) or $50.00 (incl GST) if you are a full time non-earning student

payment details

we prefer you pay by direct credit (ANZ Account: 06-0201-0631490-00). Please ensure you put your membership number and name in the reference box. If the fee is being paid by your Employer, please specify

Renew Status of Standard Membership

Are you a machine? If not please enter nothing in here:

You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you’d like a copy of your information, or want to have it corrected, please contact us at registrar@dapaanz.org.nz

Please select*

Renewing

First Name(s)*

Surname*

Membership number

Date of Birth (we collect this for reporting member statistics only)*

Ethnic Identity (we collect this for reporting member statistics only)*

African

American

Arabic

Asian

Australian

British

Canadian

Cook Islander / Pasifika

Fijian / Pasifika

Indian

Irish

Jewish

Lebanese

Malaysian

Māori

Nepali

Niuean / Pasifika

NZ European / Pākehā

Pakistani

Samoan / Pasifika

Scottish

South African

Sri Lankan

Tokelaun / Pasifika

Tongan / Pasifika

Tuvaluan / Pasifika

Other

Gender (we collect this for reporting member statistics only)*

Male

Female

Transgender

Gender Neutral

Your Job Description:*

Organisation name and town/city:*

Preferred mailing address:*

Home

Work

Preferred mailing address (for certificates):*

Mobile e.g. (64) (025) (555 5555):*

Telephone (work) e.g.(64) (04) (499 3083):

Due to work emails being blocked by some servers, we request that you supply us with a personal email address, so we can keep you up to date with any news and information

Private Email:*

Criminal Conviction, Complaints, and Disciplinary Disclosure

To reduce risk for clients, applicants are required to disclose any prior, current or pending complaints about professional practice and disciplinary actions against them, and convictions that fall outside of the Clean Slate Legislation (see below).

Please answer the following questions:

Have you been convicted of a criminal offence since your last application/renewal?*

Yes

No

Have there been any complaints about your professional practice upheld since your last application/renewal?*

Yes

No

Have you been subject to disciplinary action from your employer since your last application/renewal?*

Yes

No

If you have answered yes to any of the questions, please provide details below

Upload Disclosure Document

Additional Disclosure Document

Additional Disclosure Document

Checking this box confirms you have attached and disclosed all required information*

Note:Under the Clean Slate Act 2004 you don’t need to disclose your convictions if you meet all of the following conditions:

No convictions within the last seven years

Never been sentenced to a custodial sentence e.g. imprisonment, Corrective Training, or borstal

Never been ordered by a Court following a criminal case to be detained in a hospital due to your mental condition, instead of being sentenced

Not been convicted of a “specified offence” (e.g. sexual offending, offending against children, young people or the mentally impaired)

Paid in full any fine, reparation, or costs ordered by the Court in a criminal case

Never been indefinitely disqualified from driving

Payment Details

Please select your fee type*

Please select your method of payment*

Cheque

Direct credit

Cash

Organisation to pay (you are required to forward the invoice to your accounts team)

I require an invoice

I require a receipt

I have already made payment

Notes

Please use the box below to note important details regarding your renewal application.

Notes:

I hereby verify that all information on this form is true and correct to the best of my knowledge and agree to abide by the Code of Ethics*

Please be aware:Due to our internal processes we may take up to one month to process your application. You should expect to receive your certificate within this timeframe.